ECOG/WHO/Zubrod score[edit]

The Eastern Cooperative Oncology Group (ECOG) score (published by Oken et al. in
1982), also called the WHO or Zubrod score (after C. Gordon Zubrod), runs from 0
to 5, with 0 denoting perfect health and 5 death:[2] Its advantage over the
Karnofsky scale lies in its simplicity.
0 Asymptomatic (Fully active, able to carry on all predisease activities without
restriction)
1 Symptomatic but completely ambulatory (Restricted in physically strenuous
activity but ambulatory and able to carry out work of a light or sedentary nature.
For example, light housework, office work)
2 Symptomatic, <50% in bed during the day (Ambulatory and capable of all self
care but unable to carry out any work activities. Up and about more than 50% of
waking hours)
3 Symptomatic, >50% in bed, but not bedbound (Capable of only limited selfcare, confined to bed or chair 50% or more of waking hours)
4 Bedbound (Completely disabled. Cannot carry on any self-care. Totally confined
to bed or chair)
5 Death

ZOLEDRONIC ACIDS
Zoledronic acid slows down bone resorption,
allowing the bone-forming cells time to rebuild
normal bone and allowing bone remodeling
Zometa is used to prevent skeletal fractures in
patients with cancers such asmultiple
myeloma and prostate cancer, as well as for
treating osteoporosis.[2] It can also be used to
treat hypercalcemia of malignancy and can be
helpful for treating pain from bone metastases.[3]

TAXOTERE
Taxotere (docetaxel) is a cancer medication
that interferes with the growth and spread of
cancer cells in the body.
Taxotere is used to treat breast cancer, lung
cancer, prostate cancer, stomach cancer, and
head/neck cancer.
Taxotere may also be used for purposes not
listed in this medication guide.

Gleason Score
The Gleason Grading system is used to help
evaluate the prognosisof men with prostate
cancer. Together with other parameters, it is
incorporated into a strategy of prostate cancer
staging which predicts prognosis and helps
guide therapy. A Gleason score is given
toprostate cancer based upon
its microscopic appearance.[1] Cancerswith a
higher Gleason score are more aggressive and
have a worse prognosis.

 Pathological fractures result from the loss of mechanical

bone sustaining functions in relation to their metastatic
involvement.
Thus, two simultaneous events occur: an osteolytic bone
lesion and a traumatism which can be minimal.
There is no clear correlation between the radiological
importance of bone metastases and the occurrence of
fractures.
The commonest fracture sites are the vertebrae
(pathological collapse with risk of neurological
complications), femur (neck but also diaphysis), humerus,
ribs, iliac bone and particularly the cotyloid cavity.

 Impending fractures
Quite frequently, fractures are preceded by bone
pain which may occur at rest but is most severe
when the bone structure responds to a load (like
walking, sitting, wearing an object). This is called
the pre-fracture syndrome.
When such effort pains occur in cancer patients,
x-rays should be quickly performed to verify bone
structure (especially the thickness of the cortical
bone) in order to possibly propose preventive
surgery.